To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost.
Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale.
Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a sequential radiation boost and 61 (53%) without a boost. Eighty patients (72%) presented T3N0 disease and 32 (28%) T3N1 disease. Concomitant capecitabine was administered in 92 cases (79%) and intravenous 5-fluorouracil in 24 cases (21%). Sphincter preservation was performed in 82% of patients in the boost arm and 66% in the no-boost arm. A higher TRG was related to a longer interval between neoadjuvant treatment and surgery (p<0.001). The probability of a TRG ≥2 was 2.5 times higher in the boost arm. A gain in local control, estimated at 4% during the first 3 years after CT-RT, favored the boost arm.
The long-term results from our single-center experience confirm literature data on the role of a sequential boost in tumor response after neoadjuvant CT-RT in a series of cT3N0-1 rectal cancer patients.
Tumori 2016; 102(3): 316 - 322
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsRosario Mazzola, Giuseppe Ferrera, Teresa Cucchiara, Vanessa Figlia, Marina Gueci, Francesco Sciumè, Gioacchino Di Paola, Nunzia Scibetta, Antonio Lo Casto, Maria Pia Pappalardo, Roberto Lagalla, Filippo Alongi
- • Accepted on 29/01/2016
- • Available online on 16/03/2016
- • Published in print on 02/06/2016
This article is available as full text PDF.
- Mazzola, Rosario [PubMed] [Google Scholar] 1, 2, * Corresponding Author (email@example.com)
- Ferrera, Giuseppe [PubMed] [Google Scholar] 3
- Cucchiara, Teresa [PubMed] [Google Scholar] 3
- Figlia, Vanessa [PubMed] [Google Scholar] 1
- Gueci, Marina [PubMed] [Google Scholar] 1
- Sciumè, Francesco [PubMed] [Google Scholar] 3
- Di Paola, Gioacchino [PubMed] [Google Scholar] 4
- Scibetta, Nunzia [PubMed] [Google Scholar] 5
- Lo Casto, Antonio [PubMed] [Google Scholar] 6
- Pappalardo, Maria Pia [PubMed] [Google Scholar] 3
- Lagalla, Roberto [PubMed] [Google Scholar] 6
- Alongi, Filippo [PubMed] [Google Scholar] 2
Radiation Oncology School, University of Palermo, Palermo - Italy
Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar-Verona - Italy
Radiation Oncology, ARNAS Hospital, Palermo - Italy
Statistic Sciences Faculty, University of Palermo, Palermo - Italy
Pathology Unit, ARNAS Hospital, Palermo - Italy
Sezione di Scienze radiologiche, DIBIMEL, University of Palermo, Palermo - Italy